Healthcare Provider Details

I. General information

NPI: 1346234655
Provider Name (Legal Business Name): LINUS E ZUMBERGE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 HILLCREST DR
COLDWATER OH
45828-1507
US

IV. Provider business mailing address

5407 CLUB ISLAND RD
CELINA OH
45822-8871
US

V. Phone/Fax

Practice location:
  • Phone: 419-678-3435
  • Fax: 419-678-8511
Mailing address:
  • Phone: 419-268-2085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-11385
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: